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KMID : 1040620210270010125
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Clinical and Molecular Hepatology
2021 Volume.27 No. 1 p.125 ~ p.135
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Efficacy and safety of ledipasvir/sofosbuvir in 5,028 Mongolian patients infected with genotype 1 hepatitis C virus: A multicenter study
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Baatarkhuu Oidov
Lee Jae-Seung
Amarsanaa Jazag
Kim Do-Young
Ahn Sang-Hoon
Naranzul Nyamsuren
Enkhtuya Damba
Choijamts Nagir
Batbayar Purev
Otgonbayar Radnaa
Saruul Bat-Ulzii
Gantuul Chuluunbaatar
Gegeebadrakh Baljinnyam
Tuvshinbayar Narangerel
Badamsuren Dorjgotov
Ulzmaa Galsan
Otgonbold Jamiyandorj
Han Kwang-Hyub
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Abstract
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Background/Aims: Ledipasvir/sofosbuvir (LDV/SOF) shows high efficacy and safety in patients with genotype 1-hepatitis C virus (HCV). We aimed to investigate the efficacy and safety of LDV/SOF in real-world Mongolian patients.
Methods: Between 2015 to 2019, 23 (0.5%) and 5,005 patients (99.5%) with genotype 1a and 1b HCV, respectively, were treated with a fixed-dose tablet containing 90 mg ledipasvir and 400 mg sofosbuvir for 12 weeks, and 81 patients (1.6%) with previous experience of interferon (IFN)-based treatment received additional 1,000 mg ribavirin. HCV RNA was measured at 4, 12, and 24 weeks after the first dose to determine rapid virologic response, end of treatment response (ETR), and sustained virologic response at 12 weeks after end of treatment (SVR12).
Results: Most patients (n=5,008; 99.6%) achieved ETR and SVR12 without virologic relapse. Patients with genotype 1a showed low rates of ETR and SVR12 in only 16 patients (69.6%). There was no significant difference in SVR12 rate between patients regardless of IFN experience (n=81; 1.6%), cirrhosis (n=1,151; 22.9%), HCV RNA >6×106 IU/mL (n=866; 17.2%), or liver stiffness >9.6 kPa (n=1,721; 34.2%) (100.0%, 99.3%, 99.4%, and 99.4%, respectively). No severe adverse events (AEs) were reported, and there was no dose reduction or interruption due to AE. The most common AEs were headache (n=472; 9.4%), fatigue (n=306; 6.2%), abdominal discomfort (n=295; 5.9%), and skin rash (n=141; 2.8%).
Conclusions: LDV/SOF showed high efficacy and safety for patients with genotype 1, especially 1b HCV, in Mongolia. The real-world data might be applicable to patients in other Asian-Pacific countries.
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KEYWORD
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Hepatitis C, Chronic, Ledipasvir, Sofosbuvir, Mongolia, Real-world
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